Organization
COBORNS INC
Active
Parent organization
COBORNS INC
Other names
MARKETPLACE PHARMACY #2583
Organization subpart
Yes
Provider details
NPI number
Legal business name
COBORNS INC
Authorized official
CHAD NELLIS PHARMD (DIRECTOR OF PHARMACY)
(320) 534-2743
Entity
Organization
Contact information
Practice address
10514 MAIN ST, HAYWARD, WI 54843-6720
(715) 634-1817
(855) 304-4787
Mailing address
PO BOX 6146, PHARMACY OFFICE, SAINT CLOUD, MN 56302-6146
(320) 534-2744
(320) 203-1095
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9403-42
WI
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000056023
—
WI
01
—
2159610
PK
—
Enumeration date
04/18/2016
Last updated
07/23/2025
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